Surgical dentistry

OBJECT AND CONTENT.

STAGES OF DEVELOPMENT.
Modern advances
AND PROSPECTS.

Lecture №1
- What is studying dental surgery?

- When and how was formed?

- What has been achieved so far?

- What are the current problems?

- What are the prospects for development?

 Surgical dentistry
• Independent clinical discipline that studies the
diseases and injuries of teeth, BODIES mouth,
face and neck, facial bones, requires a
comprehensive TREATMENT IN WHICH THE
OPERATIONAL METHODS ARE LEADING
border of Operative Dentistry
 Surgical dentistry

inflammatory
diseases

traumatic injuries

tumors and tumor

disease
congenital and
acquired
defects and
deformation
inflammatory processes
* septic processes caused by the introduction of a specific or non-specific infection
and aseptic processes caused by autoimmune lesions

• periodontitis
• pericoronitis
• abscesses
• cellulitis
• osteomyelitis
• maxillary sinusitis
• sialadenitis
• lymphadenitis
• TMJ arthritis
• boils
• carbuncles
• tuberculosis
• actinomycosis
• etc.
traumatic injuries
* mechanical, thermal, chemical and
radiation injuries

• bruises
• wounds

• fractures
neoplasms and
tumor-like processes
• crayfish

• sarcoma
• adenoma
• angioma
• etc.
Anomalies, defects and deformation

• birth
• purchased
HISTORY OF
SURGICAL
DENTISTRY

organizational development
 ORGANIZATIONAL DEVELOPMENT STAGES

BC

the inhabitants of ancient Egypt possessed treatments gnoynovospalitelnyh

processes of dental system, including intraosseous

• during excavations near the Saqqara found human lower jaw, presumably lived between 1570-1085gg BC With 2
exactly cylindrical drilled holes with a diameter of 2 mm and a depth of 5 mm at the level of the tops of the roots of
posterior teeth
• in papyrus belonging to VIII century BC Dental diseases described

India, Egypt, Tibet, Byzantium possessed some methods of plastic

surgery of the face and skull

China, Greece, Byzantium possessed some methods of plastic surgery

of the face and skull
• owned methods of skin grafting to restore the nose and ears
• found on the remains of people who lived before Christ there are traces of cosmetic surgery of the face and skull

Hippocrates (V BC), and later celsius Galen and Avicenna first principles
laid Surgery
• in particular, Hippocrates first described pliers to remove teeth from lead, gathering herbs for pain relief, etc.
 ORGANIZATIONAL DEVELOPMENT STAGES

START AD and MID CENTURY

the opening of the first universities and medical
schools in Europe (Italy, France, Germany,
Switzerland, England), where he taught some
techniques of surgical dentistry and plastic surgery

the growing pressure of the Christian churches in

Europe, the stagnation and regression of the natural
sciences, including medicine

• persecution of scientists, up to physical attacks

• ban any research
• a ban on the dissection of the dead

medical care becomes "popular", it provide

healers, healers, artisans, barbers,
zubovoloki, bathhouse, blacksmiths, etc.
 ORGANIZATIONAL DEVELOPMENT STAGES

MIDDLE AGES

in Russia come first doctors from Europe

• when Dmitry Donskoy in Russia come to the Greek ecclesiastical dignitaries who brought the book
of medical content. In these books address issues of treatment facial wounds, tooth removal
equipment
• during the reign of Ivan III come first occupational therapists
• at the court of Ivan the Terrible at the court has a staff of professional foreign doctors and physicians
Russian self-taught. First created Apothecary order.
 ORGANIZATIONAL DEVELOPMENT STAGES

XVII century
in Europe and Russia dentistry is not related to medicine and care to patients
by doctors is not

doctors clergy were forbidden to carry out surgical operations such

as "occupation unworthy of an educated physician"

in the XVII century Russian doctors are beginning to send self-taught to study
abroad
• first he graduated from Cambridge University in England course the famous Russian doctor P.V.Postnikov

under Tsar Alexei Mikhailovich Romanov opened the first private hospital and a
temporary military hospital
 ORGANIZATIONAL DEVELOPMENT STAGES

XVIII century
in France, and later other European countries dentistry relates to medicine and set up
a special degree - surgeon-dentist, but mass treatment goes beyond the practice of
medicine and general surgery

• among physicians and surgeons interest in dentistry, surgery, dental and oral exhibit individual researchers

• French explorer Pierre Foshar published the first guide to dentistry and dental
surgery. He is considered the founder of dentistry.
 ORGANIZATIONAL DEVELOPMENT STAGES

XVIII century
in Russia since the time of Peter I of Russia encouraged the development of science

organized by the Medical College

introduced training dentists Russian foreign specialists

dentistry to permit only graduates, supervised by the Medical Office

in 1755 it opened Moscow University, and in 1758 - Medical

Faculty
the opening of the anatomical theater and a permanent military hospital in Moscow

the opening of a military hospital and the Admiralty in St. Petersburg

 ORGANIZATIONAL DEVELOPMENT STAGES

XVIII century

in the second half of the century, opening in France, Germany, Austria, a

large number of dental schools

in the second half of the XVIII century is widely distributed professional

dentistry in Europe

in Russia built a factory for the production of medical instruments

(including for tooth extraction)

organized the first private dental practices and school zubouchenichestva

 ORGANIZATIONAL DEVELOPMENT STAGES

XIX century

widespread professional dentistry in Russia, the widespread opening of foreign

and domestic practices of dentists

the introduction of the title of "dental surgeon" with specific

requirements for applicants

with 1838. the introduction of state control over education, defined a 3-year period
of study with ekzamenovkoy at the medical faculty of Moscow University,
SanktPeterburzhskoy Medical-Surgical Academy and the University of Kiev

the first publication of the domestic professional literature

the first domestic monograph A.Soboleva "Dentistika or dental art. On the treatment of dental disease of child care
application. " The book stated indications and contraindications for the removal of teeth, describes methods of operations,
sets of tools and pliers.
 ORGANIZATIONAL DEVELOPMENT STAGES

XIX century

Organization at University School of Oral and Maxillofacial Surgery

there is a tendency to unite surgical stomatology and maxillo-facial surgery

Organization assistant professor of the Medical Faculty of Moscow State University NN Znamensky teaching
dentistry at the department of hospital surgery on the basis of fundamental sciences - natural sciences and
medicine, communication methodology Odontological surgery with topographic anatomy and operative surgery,
implementation of the antiseptic, the development of new surgical procedures, including dental implants, alveolar
curettage with Pioro

Courses Odontology at the St. Petersburg Medical-Surgical Academy (PF Fedorov) and the St. Petersburg
University for Women (AK Limberg)

organization of dental schools controlled by the state

Europe in school in Paris (1890)., London, Vienna, Berlin, Hamburg, in the United States - in
Boston, Chicago, Buffalo
in Russia - St. Petersburg (1881) (FI Vazzhinsky), Moscow (. 1892) (IM Kovarskii), Odessa, Kiev, Kharkov, Lvov,
Vilna
 ORGANIZATIONAL DEVELOPMENT STAGES

XIX century

creating dentists societies

in the late XIX and early XX century. in Europe and the United States held three dental congress, where issues
of odontogenic infections, dental field operations, including surgical methods for the treatment of chronic
odontogenic foci

appearance in the Russian educational and scientific literature in

translation, publishing local authors
"About replantation and transplantation of teeth" dental doctor V.Antonevicha (1865) "Theory and
dental caries therapy" AK Limberg (1891), "Extraction of teeth" PF Fedorov (1892)
 ORGANIZATIONAL DEVELOPMENT STAGES

beginning of XX century

selection surgical stomatology as a discipline

• PG Daugeh organized selection in hospitals beds for the wounded who needed urgent dental care, including
surgery

Organization of dental institutes faculties and departments

• the organization in 1919 in Kiev State Institute of odontological, later transformed into the Faculty of Odontology

• in 1919 - the department of odontology (dentistry then) in the Donetsk Medical Institute (NA Astakhov

• in 1920 - the department of dentistry and maxillofacial surgery at the Medical Faculty of Moscow University (LA
Govseev)
• in 1920 - the Department of Odontology and Dentistry of the Kazan Medical Institute (PA Glushkov)

• 1921 - odontological faculty of the Kharkov State Medical Institute (EM Gofung)

• in 1922 - the State Institute of Dentistry, renamed the National Institute of Dental and dentistry in Moscow, the
director of which in November 1922 became the AI Evdokimov.

expanding the network of dental clinics and offices

• by 1927 there were 1556 dental office
 ORGANIZATIONAL DEVELOPMENT STAGES

beginning of XX century

networking hospitals and hospitals for the sick and wounded in the
maxillofacial region
• PG Daugeh organized selection in hospitals beds for the wounded who needed urgent dental care, including
surgery
• organized hospitals jaw, jaw separation during surgical hospitals in Petrograd, Moscow, Smolensk, Kiev, Kharkov,
Odessa, Polotsk, Minsk, Warsaw, Riga, Tbilisi and other cities with a total of 3,000 beds, of which 1150 in Moscow
and 600 in St. Petersburg
• discussion of the treatment of jaw injuries at the Extraordinary Congress of the Pirogov (1916)
• approval in 1917 by the Council of the army and navy doctors at the Main military-sanitary management of the situation, "On
the organization of dental care in the army", which provided for the introduction of the maxillary and mandibular branches of
hospitals with surgical hospitals.
• specialization general surgeons in maxillofacial surgery (NV Almazov, Limberg AA, AE Rauer, NM Michelson, A.
Govseev, VA Gusynin, BV Parin , ZM Kartashov, N.N.Petrov, GA Vasiliev, Fyodor tricky Lukomsky IG)

the final formation of surgical dentistry as a separate discipline

• the organization in 1935, 11 dental institutions with departments for the discipline and the creation of
departments and laboratories in research institutes
• founder of the national surgical stomatology: A.I.Evdokimov (Moscow)
A.E.Rauer (Moscow) A.A.Limberg (Leningrad)
 ORGANIZATIONAL DEVELOPMENT STAGES

beginning of XX century

publication of fundamental works on surgical stomatology and

maxillo-facial surgery
• BB Brandsburga "Surgical treatment of jaw"
• AE Verlotskogo "extractions"
• AE Rauer "jaw fractures and damage to the soft tissues of the face"
• IG Lukomsky "war injuries of the maxillofacial area and care for the wounded"
• BD Frankenberg "Regenerative facial surgery"
• SN Vaisblat "Pyogenic osteomyelitis of the jaws"
• AA Limberg "splinting jaws"
• AA Kyanskogo "Prostheses face and jaws and technical tires"
• as well as textbooks on surgical stomatology EI Gofunga and IG Lukomsky, AA Limberg and PP Lviv

• and abroad A.Kantorowicz (1929), N.Bruhn (1932), M.Wassmund (1935), R.Baume (1943), N.Ahhausen (1934,
1937, 1947), S.Mead (1940 1946)
 ORGANIZATIONAL DEVELOPMENT STAGES

The middle of the XX century

development of military field and reconstructive surgery due to World

War II
• June 25-27, 1940 in Moscow, the All-Union Conference on Oral and Maxillofacial Surgery, summed up the experience
of the First World War and the wars of 1939-1940., Laid the foundation of the organization of the wounded with
maxillofacial injuries
• Stages of assistance: pre-medical - medical first - Specialized medical
• the publication in the early years of the Great Patriotic War on the organization of the wounded orders "for emergency and
first aid instructions special maxillofacial injured and evacuate them in time of war" (1941)

"Assistance Guide for wounds jaws ships ive parts of the Navy" (1941)

instruction "medical evacuation service of wounded in the face and jaw" (1941) "Guidelines on the treatment of
maxillofacial injuries" (1942) statement "Treatment of maxillofacial injuries in the evacuation hospital" (1942)
"Regulations on the evacuation and sorting of maxillofacial injuries "(1942)" Regulation of maxillofacial hospitals
Narkomzdrav system USSR and maxillofacial surgical departments with common base hospital "(1942) and others.

• Leading experts have played a major role in the development of surgical stomatology and maxillo-facial surgery in
the years of war the Red Army Chief Dentist D.A.Entin chief dentist Navy V.M.Uvarov

senior specialists and other fronts. L.V.Aks, L.R.Balon, I.A.Begelman, L.I.Berger, M.K.Geykin, Ya.M.Zbarzh,
I.P.Kalineyko, K. F.Krayzmer, A.A.Kyandskom, L.Yu.Katsenelson, A.M.Rarog, V.V.Fialkovskoy, G.A.Vasilev,
A.I.Rybakov, E.V.Gruzdkova, VP Zabelin N.N.Ezhkin, G.M.Ivaschenko, V.I.Kulazhenko, P.I.Popudrenko, M.A.Shvarts,
S.M.Davidson, A.P.Klimenko, I.L.Livshits, V.I.Zausaev, M.A.Makienko, G.I.Semenchenko, A.A.Limberg, P.P.Lvov,
B.N.Bynin, A.I.Evdokimov, I.G.Lukomsky A. E.Rauer, N.M.Mihelson, F.M.Hitrov, V.F.Rudko, V.Yu.Kurlyandsky,
M.V.Muhin, E.M.Zhak et al.
 ORGANIZATIONAL DEVELOPMENT STAGES

the second half of the XX century

consolidation of existing scientific and academic institutions and the opening in the
large cities of the USSR of new medical schools and dental schools

which at various times was headed to Moscow Medical Dental Institute - A.I.Evdokimov, G.A.Vasilev, V.F.Rudko, V.I.Zausaev, I.S.Karapetyan,
T.G.Robustova in Moscow Institute of Postgraduate medical - N.M.Mihelson, V.S.Dmitrieva, I.I.Ermolaev, V.A.Sukachev, V.M.Bezrukov,
A.I.Nerobeev; in the Leningrad Military Medical Academy - D.A.Entin, M.V.Muhin, B.D.Kabakov, N.M.Aleksandrov, V.N.Balin, at the Naval
Academy - V.M.Uvarov; at the Leningrad Medical Institute and the Institute of Postgraduate Medical - A.A.Limberg, A.A.Kyandsky,
V.A.Dunaevsky, M.M.Solovev, VAKozlov.

Department of Operative Dentistry in medical institutions was headed in the Tver - P.V.Naumov, R.D.Novoselov, V.V.Bogatov in Perm -
S.F.Kosyh, A.F.Ivanov, M.V.Kostylev, B.L.Pavlov, F.I.Kislyh in Krasnodar - V.A.Kiselev in Krasnoyarsk - A.A.Levenets in Samara -
M.M.Makienko, I.M.Fedyaev in Smolensk - A. G.Shargorodsky in Arkhangelsk - S.N.Fedotov in Yekaterinburg - L.P.Malchikova in Chita -
V.A.Lyubarsky, A.S.Pinelis in Kazan - E.V.Domracheva, LA Koltsov, E.A.Kreshetov, I.G.Yamashev in Novosibirsk - P.G.Sysolyatin in Stavropol
com - M.M.Slutskaya, S.I.Kaganovich, M.P.Vodolatsky, E.I.Osipyan in Izhevsk - A.I.Pantyuhin in Kemerovo - V.T.Timirhanov in Voronezh - AI
.Evdokimov, N.G.Popov, M.A.Gubin, N.G.Kosyh in Irkutsk - K.K.Alkalaev, E.N.Malkov, R.V.Ushakov in Omsk - A.M.Nikandrov , P.I.Ivasenko in
Volgograd - E.Ya.Klyachko, N.A.Gruzdev, E.V.Fomichev in Khabarovsk

- V.I.Goppe in Ufa - V.F.Tatarinov, G.G.Mingazov in the North Ossetian - L.M.Totrova in Dagestan - M.M.Magomedov, A.Asiatilov. In the
development of surgical stomatology mattered activities of professors and associate professors who created the department of pediatric dentistry
- L.M.Obuhovoy,
N.I.Agapova, M.P.Oskolkovoy, A.A.Kolesova, B.Ya.Bulatovskoy, L.E.Frolovoy,
E.Yu.Simanovskoy, R.D.Novoselova, B.N.Davydova et al.
The USSR successfully worked Department of Operative Dentistry at the Kiev Medical Institute and the Institute of Advanced Medical
(Yu.I.Vernadsky, A.M.Solntsev), Kharkov (S.N.Vaysblat, M.F.Datsenko, Yu.F.Grigorchuk, G .P.Ruzin) Odessa (B.D.Frankenberg,
G.I.Semenchenko) Poltavsky (N.D.Lesovaya, V.F.Chistyakova, O.V.Rybalov) Lvov (E.V.Gotsko) , Dnepropetrovsk (E.M.Malevich,
O.E.Malevich), Donetsk (N.A.Astahov, EN Samar) medical institutions, the Minsk medical Institute and the Institute of Advanced medical
(O.P.Chudakov, GV .Kruchinsky), Tashkent com Medical Institute and the Institute of Advanced Medical (M.V.Paradoksov, L.E.Frolova,
N.N.Mazalova, E.U.Makhamov), the Tbilisi Medical Institute (A.N.Ediberidze, A.A.Bregvadze on improvement of doctors - ON Nemsadze),
Baku (G. Kurbanov T. Babayev), Alma-Ata (JB Urazalin), Kyrgyz (YM Snezhko), Turkmen (Dadalyan), Dushanbe (M. E.Muhsinov) Yerevan
(G.M.Egiyan, H.A.Badalyan, S.G.Anayan) Chisinau (N.V.Fetisov, D.I.Titarev, A.E.Gutsan), Vilnius (C .P.Chepulis, G.P.Sabalis), Riga
(V.A.Aronson, A.A.Skager) medical and tute.
 ORGANIZATIONAL DEVELOPMENT STAGES

90-ies of XX century

selection Maxillofacial Surgery

separate special
HISTORY OF
SURGICAL
DENTISTRY

scientific development
 STAGES OF SCIENTIFIC DEVELOPMENT

to the XVIII century

• lack of basic knowledge of anatomy, histology, microbiology, etc

.;

• lack of basic surgical and anesthetic skills ( preventing pain, stop bleeding, wound
treatment, etc.) ;

• lack of diagnostics;

• experience in the treatment of purulent processes;

• some experience of moving flaps, transplants of biological and synthetic

materials ( Transfer skin flap on the leg, dental grafts, plastic sky gold plates and so forth.) ;

• primitive tools;

• herbal experience;

• knowledge of acupuncture and manual therapy

 STAGES OF SCIENTIFIC DEVELOPMENT

XIX century

Factors which determined the rapid development of surgery:

• development of basic sciences (physics, chemistry, biology)

• accumulation of medical knowledge:

- of normal and topographical anatomy;
- the discovery of microorganisms
- L. Pasteur discovery of the causes of suppuration and fermentation;
- opening Dzh.Listerom principles of antiseptics;
- the opening of the general funds (Jackson, U.Morton, Warren, Dzh.Simpson)
and local anesthesia (Mays, Anrep Koller)
- opening V.K.Rentgenom rays
- developing principles operative surgery (wound treatment, stopping
bleeding and so forth.)

• industry development

• numerous wars with a large number of firearms and mechanical damage to the
maxillofacial region
 STAGES OF SCIENTIFIC DEVELOPMENT

XIX century

the introduction of surgical dentistry general and

local anesthesia
• 1846. dentist J.Morton first anesthetized with ether removed a tumor in the
submandibular region
• 1884. V.Holsted held its first regional anesthesia of the infraorbital nerve and
nizhnelunochkovogo cocaine solution
 STAGES OF SCIENTIFIC DEVELOPMENT

XIX century

the introduction of surgical stomatology of aseptic and antiseptic

 STAGES OF SCIENTIFIC DEVELOPMENT

XIX century

the expansion of the volume of transactions

• 1820 Professor of the Moscow University of AI Paul developed the methodology of some
operations, including resection of the mandible.
• 1843 IV Buyalsky successful resection of the lower jaw, simplifying operation.
 STAGES OF SCIENTIFIC DEVELOPMENT

XIX century

introduction of orthopedic techniques in maxillofacial trauma and the

development of military surgery
• NI Pies developed first classification of lesions of the oral cavity, the first gypsum model created chin sling indicated the
need for conservative (gentle) tactics processing entity gunshot wounds and even proposed a probe for feeding and
drinking bowl injured jaw.

• NV Sklifosovsky (1878) described the peculiarities of the wounds of the maxillofacial region, to generalize the experience of the
treatment and the care of patients with such lesions.
 STAGES OF SCIENTIFIC DEVELOPMENT

XIX century

introduction of Plastic and

Reconstructive Surgery
1808 F. Bush did surgery for "cleft lip".

Pirogov and Yu.K.Shimanovsky developed a framework of plastic

maxillofacial surgery. rhinoplasty development methods
(Yu.K.Shimanovsky, Dieffenbach, Kuster)

Free grafts (Jatsenko, Reweden, Tirsch, Kranse, Wolf)

uranoplasty (Lexer, Israel)

bone grafting (Deacon, Petrov, Langenbeck, Israel, Hardie)

plastic cloth on the pedicle (Filatov, Lexer,

G.Bardenheuer)
implantation and endoprosthesis (K.Martin, Hall, Partsch, Schroder)
 STAGES OF SCIENTIFIC DEVELOPMENT

beginning of XX century

improving the treatment of pain

• in 1905. A.Eynhorn synthesized procaine, B. Braun performed the first operation under anesthetic procaine

• development of methods of inhalation, intravenous and rectal anesthesia

improvement of methods of treatment of jaw fractures

• SS Tigerstedt (1914) proposed a method for the immobilization of bone fragments through the jaws of tooth wire
bus
• GI Wilga (1915) developed a method of fixing fragments of jaw-cap stamped with elastic tires traction

• implementation of operative fixation of bone fragments

implantology and transplantation development

• in 1900. V.M.Zykov offer free bone autoplasty
• Immediate introduction of prosthetics-resected bone segments

diagnostics development
• implementation of radiological techniques
 STAGES OF SCIENTIFIC DEVELOPMENT

The middle of the XX century

improving the treatment of pain

• in 1943. Nils Lofgren synthesized lidocaine
• introduce the method of endotracheal anesthesia

development of orthognathic surgery

the introduction of antibiotics

development of military surgery and traumatology

• revision principles primary surgical treatment of wounds

development of reconstructive surgery

• introduction of primary reconstruction of lost or damaged tipped
• the formation principles of biocompatibility

diagnostics development
• improving radiological techniques
• introduction of physical methods (termoviziografiya, electrophotography, electrical and
electroexcitability and so on.)
 STAGES OF SCIENTIFIC DEVELOPMENT

the second half of the XX century

improving the treatment of pain
• anesthetics of amide synthesis of (trimekain, bupivacaine, etidocaine, articaine, etc.).

development of free plastic methods

• free bone transplantation (allo and autologous transplantation)
• transplant tissues using microvascular anastomoses)

introduction of methods of guided tissue regeneration

• method of bone distraction
• method dermotension

implantology development
• arthroplasty bone structures of the maxillofacial region
• dental implantology
• introduction biomechanically compatible material
• the introduction of induction resorbable materials

implementation of the principles of organ surgery

The present
surgical dentistry
diagnostics
history
inspection palpation
general clinical percussion auscultation

methods
blood urine
survey analysis
Biochemical analyzes bacteriological
laboratory analyzes immunoassays

X-ray X-ray computed tomography magnetic

resonance imaging

scintigraphy
beam

measurement of blood pressure

Electrocardiography
Electroencephalography spirometry myography
sialometriya
functional

rhinoscopy
laryngoscopy
endoscopic sinusoskopiya
arthroscopy
esophagoscopy

cytologic histological

morphological

thermography histo of
chemically
ultrasound procedure
e
physical

neuropsychiatric
Prospects for development in the XXI century

• Gene and cellular technologies

• endoscopic technology
• laser technology
• Robotics